Canada, April: Under-65 excess mortality exceeds under-65 Covid-19 deaths
www150.statcan.gc.ca
www150.statcan.gc.ca
Kind of understating things here. There's a toxic drug crisis in this country and it has killed thousands upon thousands in recent years. This was happening well before the pandemic.
Literally 5 people every day in British Columbia are dying due to overdoses, directly related from the fact that the drugs are poisoned, not what they appear, and it has become impossible to ascertain a correct dosage.
This should be an election issue (Canada is having an election issue atm) but sadly it won't be. BC's health officer, who everyone has listened to during this pandemic, has begged the Federal government (the Province and City of Vancouver also begging) to decriminalize drugs to help with this issue, but the Feds have done nothing.
Viewing addiction as a moral failing rather than a maladaptive coping mechanism for a miserable existence and/or untreated mental illness is holding progress back.
For many, the substance one is addicted to generally starts out as something seen as fun and enjoyable. Take alcohol, the most widely celebrated addictive toxin in the world.
Stick with it for a bit, integrate into your life as a crutch (bad social skills, try drinking! need a way to relax, try drinking! bored, try drinking!) and eventually the effects of withdrawal keep you hooked. Even if you think you're not hooked, there's a chance you are.
It's a slide that is very difficult to travel in the opposite direction on. Some people will certainly slide further down due to life circumstances, but that's not really the problem, is it? You can't eliminate the fact that life is eventually going to really suck at one time or another.
The problem is that we allow companies to profit from addictive and usually harmful substances, and they are incentivized to keep people addicted. Alcohol, tobacco, and opiates - the root of an astounding amount of poor health, financial struggle, and early death among otherwise ordinary people.
Addiction isn't a moral failing of the individual as much as it is one of society, but in my opinion, for different reasons.
Think about it, there's real truth to it.
I see a moral failing here.
My stance is that the majority of people regularly using some substance probably sit somewhere on the spectrum of addiction.
Most people just never bother to quit, because it hasn't caused too much of an interference. Or if it has, they say they'll "cut back." Soon enough they're right back where they started.
Addiction can exist in very subtle ways. It creeps up. It's also highly stigmatized, so nobody wants to admit that they're dependent on a substance.
With the exception of caffeine of course. Most people will openly admit their addiction to caffeine.
Overdoses happen because people are doing hard drugs while alone and/or are getting bad drugs. Prevention of overdosed means not locking up addicts for basic possession. Safe injection sites. Basic communication services such as handing out cellphones to addicts can make a huge difference (the cost of one ER visit will buy 100 cellphones). These things can be done now.
Stopping people from becoming addicts is different. It requires societal change so that people don't land in situations where they are likely to turn to drugs. That means employment programs. That means post-hospital monitoring of patients. That means decent affordable housing. That means much more expensive and long-term efforts.
The dosage makes it poison, so it is an overdose if a properdose was sort and personally misjudged.
I'd say that there's more agreement than disagreement. Here 70% of the overdoses are related to drugs cut with unpredictable levels of fentanyl. I'd say I've seen consensus on that being a "bad thing(tm)", and consensus that the criminals cutting street drugs with fentanyl are "bad guys(tm)".
I guess to your point about junkies making bad decisions, my peer group skews older, we've already said everything we can say about junkies making bad decisions 30+ years ago. It's true, but it makes for stale conversation and seems kind of orthogonal to, or at least adjacent to, the current fentanyl situation.
Alright, I'm going to poke the bear. How would decriminalization help? I'm assuming that by decriminialization, you mean legalizing the consumption, but not sale of drugs. If so, that doesn't solve the problem of the production of drugs, which IMO won't result in the changes that you want to see (drug users dying).
It’s long past time for us to follow suit.
[1] https://www.theguardian.com/news/2017/dec/05/portugals-radic...
[2] https://time.com/longform/portugal-drug-use-decriminalizatio...
> In July 2001, a new law maintained the status of illegality for using or possessing any drug for personal use without authorization. The offense was changed from a criminal one, with prison as a possible punishment, to an administrative one if the amount possessed was no more than a ten-day supply of that substance.[2] This was in line with the de facto Portuguese drug policy before the reform. Drug addicts were then to be aggressively targeted with therapy or community service rather than fines or waivers.[9] Even if there are no criminal penalties, these changes did not legalize drug use in Portugal. Possession has remained prohibited by Portuguese law, and criminal penalties are still applied to drug growers, dealers and traffickers.[10][11] Despite this, the law was still associated with a nearly 50% decrease in convictions and imprisonments of drug traffickers from 2001 to 2015.[12]
https://en.wikipedia.org/wiki/Drug_policy_of_Portugal#Regula...
Unfortunately decriminalization is only a bad half-solution and all of those who profit off of both sides of the drug war will continue to exist, as will the inconsistent, contaminated, or mislabeled doses that are most fatal. It is absolutely imperative that we legalize nearly all recreational drugs along with regulatory measures to ensure that these medications are available OTC as standardized individually-packaged doses.
The minimization of harm from drug abuse does also depend on broader societal factors (e.g. wealth inequality), and the transition will be complex, but there are measures to be taken that could drastically cut down on overdoses deaths in no more than a few weeks.
Indeed this is the difference between decentralization and legalization.
They did a lot of things yes! Very true. I advocate for the whole model.
PS. I always assumed that decriminalization and legalization are synonyms because it never crossed my mind that possessing a tiny quantity of a substance, even illegal, can lead to jail. I'm all for decriminalization of 'personal use' quantities of any given drug.
No, I think any drugs that have been measured and studied to be less harmful than alcohol should be completely legal. And so that is, checks notes all of big ones. [1]
I see decriminalization as a minimum. I do also think a legalization or decriminalization strategy should take into account the harms associated with these substances and offer programs to mitigate social and individual harms.
[1] https://www.economist.com/graphic-detail/2019/06/25/what-is-...
Table 1 shows that before the war, 11% of the group surveyed used narcotics. In Vietnam it spiked to 43%. When they got back? 10%. [1]
For most of them, it was heroin. They literally cold turkey quit heroin when they got back from Nam.
What all this tells me is that telling addicts they can’t have drugs and sending them to prison won’t stop them from doing drugs. What will is making them not want to do drugs by changing their situation.
[1] https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.64.12...
Prison for drug use is cruel punishment, but therapy & community service (hello Portugal) are entirely reasonable (and effective!) approaches to the problem.
There is also a broader issue of stigma. If the illegal stigma around drug use goes away, and addictions are treated more like a medical issue, it is thought that it will be more normalized for drug users to get help instead of shying away.
On the opposite side there is also a stigma around medical professionals helping "addicts" that are breaking the law and many doctors are reluctant to touch these sort of health issues with a 10 foot pole. Decriminalization could help do away with this problem and pave the way to prescription of a safe supply of drugs.
Drug users having a prescribed safe supply of drugs is the ultimate solution to the core problem here of a utterly toxic drug supply.
You can see the difference clear enough to make inferences.
There were a lot of people in the scientific community, Perhaps the majority, suggested Sweden’s method was superior to what many other countries were doing.
The fact is, people are effectively believing what they want. There wouldn’t be a need for censorship if the truth was clear.
Sweden is apparently much more dense in the cities, has larger cities, bigger migrant population etc so apparently making comparisons across Scandinavia isn’t as helpful as you would expect.
I think one day you might be able to get a good definitiveish answer. For instance, you can assume that everyone gets covid in the "no measures" case, and extrapolate death rates using serosurveillance to get the portion of the population infected in reality. Once Covid is "over" you can see the number of people who died in reality.
There will always be all sorts of errors in such an estimate. From bad data, to things like death rate depending on your assumptions about variants, vaccines, and the make up of the population. But once we get the "how we did in the end numbers" it's plausible that we can make some sort of comparison to "how we could have done".
I'd say stopping at number of deaths is a better metric.
A. Lockdowns have costs. Deficits that will take decades to pay off. Lives lost to alcohol and depression. Economic hardship. A lost education year. Etc.
B. The pandemic has vastly different risk profiles for different age groups. At an extreme, under 20s have 1/1000 fatality risk compared to over 70s. It is fundamentally faulty to design a blanket one size fits all policy under such circumstances.
I went to a local mall a few days ago, and the amount of stores that went out of business because of the lockdowns is rediculous. I wouldn't be suprised if the whole mall has to close down soon, there's no way it's profitable to keep it running with 2-3 snack vendors and a couple of barber shops / nail salons being the major businesses left.
That said, measures like GP described were/are in play in many cities. Seniors time was a fixture in the first few months of the pandemic, especially in smaller areas that did not experience a large caseload.
That's another point too: I think a lot of HN commenters are unaware of just how fragmented and regional the Canadian healthcare system is. No two provinces implemented the same restrictions or policies at the same time, and only a couple put in strict stay-at-home style lockdowns. Note how the article mentions large increases in both Ontario (lax policies, then sudden strict lockdowns) with Alberta (very few restrictions). Even in Ontario, walking outside the biggest few cities would result in an immediate drop of most of the strict measures present in, say, the GTA. I know it's hard to capture this nuance discussing with strangers on some random online forum, but it's essential if we are to properly discuss cause and effect.
Neither of your points A or B are at all discussed in this data, nor are they responsive to my comment. I'd classify them as largely off topic and I'm not going to respond past pointing that out. The data at hand does not discuss financial costs of either lockdowns or letting people get sick. Does not compare risks between different age groups (apart from giving number of deaths under 65). Does not discuss policy ideas. Etc.
Another way to do it would he to compare only the under 65 per capita infection rate in a similar country (could also be Netherlands) that had no lockdown and use the mortality rate for that demographic in the first country (which would be Canada in this case) and determine roughly how many lives were saved.
We can’t compare the costs to the deaths we’ve had from terrorism since (zero) we need to compare it to all the terrorism deaths that were prevented.
See why that’s a bad argument?
The delta variant in India is much more infectious, but also much less deadly to the population there. Exactly the change you expect a virus to make overtime, since killing the host tends to end the viruses ability to spread. Its turning into cold, or mild flue.
This virus was only ever a real threat to the elderly, who still control most of the wealth, and vote in large numbers. What you're seeing is politics of self preservation of the eldest generation on the way out, at the expense the younger generations. Much like hoarding resources, they continue to quench to life. At some point younger people will rebel if this continues.
The real threat is return to authoritarianism. It has killed tens of millions in the last century.
Thats pretty damning for the government and a confirmation of what anti-lock down protesters have been saying since last year.
If they let under 65s free while sheltering the vulnerable and keeping mask and distance protocol would there be 4x the covid deaths, probably not.
And we could have avoided the ~$400+ billion dollar deficit.
[1] https://www.aei.org/op-eds/the-coronavirus-is-killing-thousa...
[2] https://www.cbc.ca/news/politics/cerb-pandemic-opioid-addict...
...
And I don't believe we have even begun to see the psychological / developmental effects of isolation and distance learning on young kids.
I mean, from your own link:
> We don’t have data that the lockdowns are causing more suicides,
Now, like all estimates, I am sure there are errors, but it's not like they haven't done their homework.
There isn't enough data in the paper to blame the lockdown per se, however. E.g., it could be that the media fear-mongering is driving people crazy more than usual. There is no way to tell.
I'm glad people are finally admitting that there could be problems with covid testing.
Thank you gc.ca for covering something with hard fact. Living in another country with statistically provable damage driven by recent policy (that by scale is demonstrably larger than the benefit) it's a difficult position to hold even with data as you will be called alarmist, heartless or nonsensical.
It's very unfortunate to read this, I wonder does anyone know does Canada's policy on marijuana at all correlate with this recent problem (akin to Scotland thinking relaxing drugs policy wouldn't be making things worse) or is this driven by other causes?
(Genuine question sorry, did some quick googling but I must be getting tired I'm getting conflicting information)
My gut feeling is probably not, legalizing marijuana definitely made marijuana more popular, but I haven't seen any reason to believe it's increasing the popularity of still illegal drugs or alcohol (the sources of these deaths). If anything I would expect that it competes with them (but again have no data to back that up).
Not sure what data would show that, maybe if there was a strong increase associated in time with legal drug policy change(s)? Other than that, I suppose a link between prosecutions and deaths...
I worry that lockdowns haven't helped situations like this, but saying that is... inflammatory...
2019-2020* 115,126
2018-2019 109,019
And the overall death rate is roughly inline with the population growth, which is about 1.7 percent and normal variation. If official number of COVID deaths is accurate. 9,400 people died of COVID in Ontario.
Assuming those 9,400 deaths were all in the ICU and none at home or palliative care. There are 400 hospitals in the Province. So average of COVID deaths per hospital/per year is 9400/400 = 23.5
I can easily see how 23 more people in a community serviced by a hospital could have committed suicide due to drug abuse over losing their business, job, or livelihood or just being locked up with nothing else to do but think.
Also, I know it's not standard, but this almost wants a '(July)' (or even April?) in the title. Not to mention that it's not the original title.. but then, much like a tweet, the submitter's just trying to call out the relevant/intended part of a much broader page.
Hate to break the news to you but the Canadian healthcare system collapsed a long time before Corona. Just ask anyone who has been to a hospital in Toronto before Corona.
Disclaimer: EXPAT who has used both.
At least, there is in BC. Each province manages health care as they see fit.
This ranking says it's 24 in the world, after excluding microstates (anything under 1 million people): https://worldpopulationreview.com/country-rankings/best-heal...
And the solution for an already collapsed health system is to overload it even more with a pandemic, right?
I'm told that the wait time for very-specialized specialists is unreasonable long (and believe it), but the general standard of care here is very good.
Or you can “know” people then you can get it done tomorrow.
1. Potential appendicitis. Got a cat scan within hours of arriving at the hospital. Admittedly if this was actual appendicitis it would be a "about to die in the next month without surgery" situation (turned out not to be).
2. Weird long term issue relating to alcohol causing a literal pain in my side (sharp pain, relatively minor). Completely non-urgent, this existed since I first drank alcohol and the most likely explanation is that "some peoples bodies just don't like alcohol".
The doctor first asked for a ultrasound to diagnose that, no appointment necessary, literally walked into the ultrasound place, gave them the paperwork, got an ultrasound, walked out in under 20 minutes.
Ultrasound from that didn't end up turning up anything useful, so the doctor asked for a chess x-ray. This time an appointment was necessary, I made it via phone that night. A spot was available the next day. Again I walked in, got an x-ray, and left in under 20 minutes.
Various other tests (e.g. bloodwork for a few things) followed a similar pattern.
I do live in Toronto, and these experiences were downtown (the non-hospital imaging was all done in the kensington health building, I think the hospital was east general), which has a higher concentration of health services than most of Ontario/Canada.
But the culture isn't what we are comparing. What we are looking for is the comorbidities in the age range of 0-65 in both countries. They have similar climate ranges, similar eating habits, similar healthcare systems, similar genetics, etc. So we should expect that under similar covid contingencies we would get similar mortality in that age group. We wouldn't of course get exact equal values, at the very least random variance would introduce some discrepancy, but we can get a very good idea of what would've happened to that age range in Canada had there been no lockdown measures.